Bone Cancer

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What kinds of bone cancer occur in children?

Osteosarcoma, the most common type of bone cancer, is most common in older children, teenagers, and young adults. Ewing sarcoma is a bone cancer that typically affects children.

What tests are used to diagnose bone cancer?

A variety of imaging tests may be used to detect bone tumors, including bone cancers. Very early bone cancers may or may not be apparent on plain X-rays. CT scans and MRI scans are more precise in defining the location of bone cancers.

A bone scan is a test that uses radioactive material to produce images of the entire skeleton. This may allow the localization of bone cancer anywhere in the body. This test is not specific for bone cancers and can also reveal areas of inflammation as found with arthritis, fractures, and infections.

While many bone cancers have a characteristic appearance on imaging studies, a biopsy (tissue sample) must be taken in order to precisely determine what kind of cancer is present and confirm the diagnosis. The biopsy is a procedure to acquire a sample of a piece of the tumor that is examined under a microscope. The tissue sample may be obtained with a needle inserted through the skin into the tumor or with a surgical operation.

At present, there are no screening tests available to detect early bone cancers.

What is the treatment for bone cancer?

An operation to remove the cancer is the mainstay of treatment for bone cancers. Surgical techniques can remove most bone cancers without requiring amputation of the affected limb. Sometimes, muscles and other tissues that surround the cancer also have to be removed. Reconstructive surgery may be needed, in addition to cancer resection, to help maximize function of the limb.

Ewing sarcoma, osteosarcoma, and other bone cancers may require chemotherapy in addition to surgery.

Radiation therapy is the typical treatment for chondrosarcoma.

Ewing sarcomas that do not respond well to high-dose chemotherapy may require radiation therapy and even a stem-cell transplant. In this procedure, the patient's stem cells (blood cells that have the potential to develop into all the different kinds of blood cells) are harvested from the bloodstream. After high doses of chemotherapy medications to destroy the bone marrow, the harvested stem cells are next returned to the body, as with a blood transfusion. Over the next three to four weeks, the stem cells produce new blood cells from the bone marrow.

Targeted therapies are specially designed treatments that aim treatment specifically at the cancer cells. For example, denosumab (Xgeva) is a monoclonal antibody that acts to block the activity of specialized bone cells called osteoclasts. This medication has been used in the treatment of giant cell tumors of bone that have recurred after surgery or cannot be removed by surgery. Imatinib (Gleevec) is a targeted therapy drug that can block the signals from certain mutated genes that cause tumor cells to grow. Imatinib has been used to treat some chordomas that have spread or recurred after treatment.

Medically Reviewed by a Doctor on 11/12/2015

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